Duurzaam gewichtsverlies 2 jaar na laparoscopische maagbandplaatsing wegens morbide obesitas

To analyse the results of the laparoscopic adjustable gastric banding (LAGB) procedure for morbid obesity.

Design

Retrospective, descriptive.

Method

From November 1, 1995 to May 31, 2005, laparoscopic adjustable banding surgery was performed in St. Antonius Hospital, Nieuwegein, the Netherlands, in 411 patients. Inclusion criteria were BMI ≥ 40 kg/m² or BMI ≥ 35 kg/m² and severe comorbidity with ≥ 3 attempts at weight loss in the past. Selection, inclusion and follow-up were performed in a specialised, multidisciplinary setting. Height, weight, and complications were prospectively recorded. In 1995-2000 the perigastric surgical procedure was used and in 2000-2005 the pars-flaccida method.

Results

The study group consisted of 350 (85) women and 61 (15) men with a median age of 38 years (range 17-60). Out of these 411 patients, the median weight was 133.4 kg, the median overweight, 69.6 kg and the median BMI 46.3 kg/m². Two years after surgery, data was known for 267 patients where 206 (77) had a weight loss ≥ 30, and 7 patients (3) a weight gain. The median BMI difference was then –10.2 kg/m² (range +4.7-–26.4). The median loss of overweight was 46.3 (+10.00-–97.8). The weight loss remained stable in the following years. The most commonly seen complications were fundus slippage (13) and port-a-cath related complications (7). These occurred more often in patients who had had the perigastric method surgery than in the pars-flaccida surgical method.

Conclusion

Three quarters of the patients with morbid obesity who received laparoscopic gastric banding surgery had achieved and sustained weight loss at 2 years following surgery. The pars-flaccida method resulted in fewer complications than the perigastric surgical method.

Ned Tijdschr Geneeskd. 2007;151:1130-5